主动脉夹层腔内隔绝术中超速抑制降压与传统降压方法对比研究

目的比较主动脉夹层腔内隔绝术支架释放时右心室起搏超速抑制降压与传统降压方法可控性及效果。方法选择拟行主动脉夹层腔内隔绝术患者40例,男25例,女15例,年龄33～77岁,将患者随机均分为两组(n=20):右心室起搏超速抑制降压组(A组)和传统降压方法组(B组)。A组和B组麻醉诱导和维持方法相同,只是在支架释放时,A组采用右心室起搏超速抑制降压,而B组则采用药物传统降压方法使主动脉血压达到60～70mmHg。分别于支架释放前5min(T1)、释放期间(T2)、放后5min(T3)、10min(T4)、15min(T5)抽取桡动脉血行血气分析,记录pH值、乳酸和血糖浓度。记录降压达目标时间、恢复血压时间及使用升压药情况。结果与B组比较,A组pH值、乳酸和血糖浓度变化在正常范围,而降压达目标时间、恢复血压时间及使用升压药情况明显小于B组(P<0.05)。结论使用临时起搏器,超速抑制降压快速、精确、稳定。

In endovascular exclusion of aortic dissection by using overdrive suppression for decreasing blood pressure in combination with traditional ways for decreasing blood pressure

Objective To compare the efficacy of using overdrive suppression for decreasing blood pressure in combination with traditional ways for decreasing blood pressure in endovascular exclusion of aortic dissection.Methods Forty patients,between 33 and 77 years old,presenting for surgery requiring in endovascular exclusion of aortic dissection,were randomly assigned to one of two groups(n=20 each):overdrive suppression group(group A)and traditional ways group(group B).Blood sample was taken from aortic for blood gas analysis and at 5 min(T1)before endovascular exclusion,endovascular exclusion(T2),5 min(T3),10 min(T4),15 min(T5)after endovascular exclusion.The pH value and concentrations of lactic acid and glucose were recorded and the time of arriving target blood pressure and recovery of blood pressure were recorded.Results Compared with group B,the pH value and concentrations of lactic acid and glucose were in normal scope.but the time of group B arriving target blood pressure and recovery of blood pressure was longer(P<0.05).Fewer were required drugs in group A to improve the blood pressure.There were obvious difference between groups.Conclusions The overdrive suppression for decreasing blood pressure might be a good way in endovascular exclusion of aortic dissection.